Here's a free practice question to help you get ready to pass the social work licensing exam. Read carefully (as always!).
A social worker is conducting an intake assessment with a new client who is recently unemployed and reports feeling depressed and anxious for the past few months, with decreased sleep and difficulty enjoying every day activities. The client says that he sometimes thinks about ending his life, but says that he would never act on his thoughts because he does not want to hurt his family.
What is the most appropriate NEXT step for the social worker to take?
A) Refer the client to a psychiatrist for medication evaluation.
B) Develop a safety plan with the client and schedule a follow-up session.
C) Call 911 and request an involuntary psychiatric hospitalization for the client.
D) Explore the client’s reasons for living and coping skills.
How would you answer and why?
Taking the answers one by one (also as always):
Answer A) Refer the client to a psychiatrist for medication evaluation is incorrect because it does not address the immediate risk of suicide or provide any support or intervention for the client’s distress.
Answer C) Calling 911 and requesting an involuntary psychiatric hospitalization for the client is not warranted by the level of risk or by the client’s wishes. Involuntary hospitalization should only be used as a last resort when there is imminent danger of harm to self or others.
Answer D) Explore the client’s reasons for living and coping skills. This answer is tempting, but it doesn't address the risk of suicide or provide any concrete steps to ensure safety. While exploring reasons for living and coping skills may be helpful in reducing suicidal thoughts in some cases, it may not be sufficient or effective in others.
That leaves one answer, B) Develop a safety plan with the client and schedule a follow-up session.
The client is experiencing symptoms of depression and anxiety and has passive suicidal ideation, which means that he thinks about killing himself but does not have a plan or intention to do so. The social worker should assess the level of risk and take appropriate actions to ensure the client’s safety. In this case, the most appropriate action is to develop a safety plan with the client, which is an agreement that outlines specific steps to take when he feels suicidal or unsafe. The safety plan should include coping strategies, warning signs, triggers, supportive contacts, professional resources, and emergency numbers. The social worker should also schedule a follow-up session with the client to monitor his progress and provide ongoing support.
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